CDC History of Tuberculosis Control - Medical and Public Health ...

(NIH). Strong academic ties with the University
of Colorado’s Health Sciences Center,
collaborative teaching at the National Jewish
Medical and Research Center, consultation
with the IUATLD and WHO, and membership
on ACET provided expanded opportunities
to share the “Denver experience” and to
learn from colleagues throughout the world.
During these years, the recruitment of
Denver’s retired TB “greats” such as Gen. Carl
Temple and Drs. Roger Mitchell and Jack
Durrance to work regular hours each week in
the clinic ensured that the knowledge of the
past would not be forgotten in the excitement
of the future. Unhappily, their days of contribution
have passed, but the camaraderie
established between physicians, nurses, and
clinic staff produced an environment in which
professional creativity continues to flourish.
Challenging existing beliefs and methods has
become standard operating behavior. The
entrance of Randall Reeves and later of Bill
Burman ensures that it will continue, highlighted
by their scientific leadership in the TB
Trials Consortium.
The underlying philosophy driving the Denver
TB Clinic is perhaps best summarized in
two quotes from a 1970 publication, “The
Public Health Tuberculosis Clinic, Its Place in
Comprehensive Health Care” (Am Rev Respir
Dis 1970;101:463-465):
In the private sector, “even with the
best intentions of the physicians and
staff, the actual responsibility for care
rests with the patient. In TB control,
the responsibility for care rests with
the clinic.”
“...the clinic is the best way to husband
the meager resources of personnel and
money and the only way to fix responsibility
on the providers of service
rather than on the recipients... ”
TB Control at the Millennium
18
Denver’s TB program was, and is, based upon
the principle that it is responsible for curing
the patient. In the long run, the persistence of
that belief is the true foundation of Denver’s
success.
National Jewish:
The 100-Year War Against TB
by Jeff Bradley and
Michael Iseman, MD
Director, National Jewish Medical
and Research Center
Denver, Colorado
National Jewish Medical and Research Center,
which celebrated its centennial in 1999, is
known today for its expertise in a wide array
of respiratory, immunologic, allergic, and
infectious diseases. At the time of its founding,
however, it had a single purpose: the care of
impoverished victims of TB.
The need for a TB hospital became acute in
Denver in the 1880s. In those days, people
believed that the dry climate of the high plains
on which Denver is located would cure
tuberculars (i.e., persons with TB disease).
Consequently, many TB sufferers spent their
last dollars coming to Colorado. By the 1890s,
it was estimated that one out of every three
residents of the state was there for respiratory
reasons.
Old National Jewish Hospital
In Denver, TB patients were literally dying on
the streets. Boarding houses often banned
“lungers,” as they were called, and many of
them were too sick to support themselves. A
woman named Frances Wisebart Jacobs recognized
the need for a TB hospital and, after